Delayed Management in Acute Abdomen: causes and consequences | ||
| IRAQI JOURNALOF COMMUNITY MEDICINE | ||
| Article 1, Volume 26, Issue 1, April 2013, Pages 78-84 | ||
| Authors | ||
| Haqqi I. Razzouki; Amer H. Salman | ||
| Abstract | ||
| ABSTRACT: Background: Acute abdomen is a serious life-threatening condition which needs prompt diagnosis and management. However, in many situations, there is a delay in management which may affect the clinical outcome and worsen the prognosis. Objectives: To determine the causes of delay in diagnosis and treatment in acute abdomen and to study the effects on prognosis. Patients and Methods: A prospective case-series study done in Al-Yarmouk teaching hospital, surgical department over a six months period from 1st of April 2011 to the 1st of October 2011.Ninety five Patients presented with acute abdomen were divided into two groups according to the duration of their symptoms. Thirty five patients who presented after 24 hours were considered delayed and 60 patients who presented before 24 hours were considered as controlled group. Both groups were followed closely and the operative findings, Post-operative complications and the final clinical outcome were documented. Results: There were 35 patients with delayed acute abdomen. The delay was due to the patient or his family in 19 (54.2%) cases and due to medical factors in 11(31.4%) patients. The most common operative finding was perforated duodenal ulcer 5 (14.2%) patients and perforated appendix 5 (14.2%) patients. Thirty (85.7%) patients developed post-operative complications mainly prolonged paralytic ileus, peritonitis and early surgical site infection. The total post operative complications were 25 (71.4%) patients and full recovery was 5 (14.3%).There were 5(14.3%) deaths due to septic shock or cardiovascular complications. Sixty patients presented within 24 hours and considered as controlled group, The most common operative finding was perforated duodenal ulcer 30 (50%) patients, and obstructed or strangulated hernia was 15 (25%) patients, the total post operative complications in this group was (25%) P-value 0.006 (significant), full recovery was found in 42 (66.6%) patients P-value 0.0007(significant), there was no death Conclusions: Although many factors causing delay management in cases of acute abdomen are mainly related to the patient, there were a significant number of cases in which the attending doctor was responsible for the delay. There was a definite relationship between the delay in diagnosis and management and the incidence of complications and Death. Keywords: Acute Abdomen; Delayed treatment; causes, consequences | ||
| Keywords | ||
| Acute Abdomen; Delayed treatment; causes; Consequences | ||
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